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Notice of federal requirements

Federal requirements related to the ExxonMobil Employee Medical Plan - Cigna OAPIN Network Only option

Grandfathered plan intent

ExxonMobil believes that most options available under the ExxonMobil Medical Plan (Medical Plan) are grandfathered health plans under the Patient Protection and Affordable Care Act (PPACA). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect on March 23, 2010. Grandfathered plan options under the Medical Plan may not include all consumer protections of the Affordable Care Act that apply to other plans. For example, most options under the Medical Plan cover some, but not all, preventive health services without any cost sharing.

Effective January 1, 2019, the Cigna option is no longer a grandfathered health plan. The Cigna option under the EMMP meets all of the requirements of PPACA.

Questions regarding which protections apply to the Medical Plan and what might cause the Medical Plan or one or more of its options to change from grandfathered health plan status can be directed to the Plan Administrator at Administrator-Benefits, P.O. Box 64111, Spring, TX 77387-4111.  You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans.

Women's Health and Cancer Rights Act

If you have a mastectomy, at any time, and decide to have breast reconstruction, based on consultation with your attending physician, the following benefits will be subject to the same percentage copayment and deductibles which apply to other plan benefits:

  • Reconstruction of the breast on which the mastectomy was performed,
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance,
  • Prostheses, and
  • Services for physical complications in all stages of mastectomy, including lymphedema.

The above benefits will be provided subject to the same deductibles, copayments and limits applicable to other covered services.

If you have any questions about your benefits, please contact Cigna Customer Service.

Coverage for maternity hospital stay

Under federal law, the Plan may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section, or require that a provider obtain authorization from the Plan for prescribing a length of stay not in excess of the above periods. The law generally does not prohibit an attending provider of the mother or newborn, in consultation with the mother, from discharging the mother or newborn earlier than 48 or 96 hours, as applicable.

You can search this SPD section by section or click here  to create a single searchable document.